Objective: Osteoporosis is a severe epiphenomenon that follows liver transplantation (LT). There is an inconsistency regarding risk factors of developing osteoporosis in LT children. In this article, we address the frequency of low bone mineral density (BMD) in LT children.
Methods: This is a prospective study performed on children aged <18 years old, referred to the Shiraz Organ Transplant Center. The study was conducted from March 2009 until March 2014. Those with at least one year passed from the transplantation were included. Lumbar and hip bone densities were checked by Dual-Energy Radiograph Absorptiometry.
Results: From the total of 84 included children, 32 (38.1%) and 52 (61.9%) were males and females respectively. The underlying diseases included cryptogenic (32, 28.1%), biliary atresia (18, 21.4%), Wilson disease (9, 10.7%), autoimmune hepatitis (9, 10.7%), tyrosinemia (6, 7.1%), acute liver failure (5, 6%), and hypercholesterolemia (5, 6%). Overall, 53 children (63.1%) had normal BMD, while 31 (36.9%) revealed lower than normal BMD. The means of lumbar and hip z scores were -1.04+/-1.47 (median of -0.75) and -0.98+/-1.92 (median of -0.60), respectively. There was no significant association between bone density and the age of transplantation, sex, weight, height, or underlying diseases (P>0.05). None of the immunosuppressive drugs were associated with low BMD. The patients who received pulse therapy showed a significantly higher rate of low BMD respective to the patients who did not receive pulse therapy (P=0.03).
Conclusion: The frequency of low BMD is relatively high in LT children. Pulse therapy may increase the risk of low BMD and osteoporosis in LT children.
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Background: The purpose of this study was to investigate the associations between variants of a promoter polymorphism of the endothelial nitric oxide synthase (eNOS) gene and clinical outcomes in acute ST-segment elevation myocardial infarction (STEMI) patients after a successful primary percutaneous coronary artery intervention (PCI).
Methods: 177 patients with acute STEMI, 82 patients with angiographically proven stable coronary artery disease, and healthy volunteers were included in the study. The primary end-point was a combined event (follow-up major adverse cardiac events â€“MACEs and hospitalization) that occurred within 6-month of the discharge from the hospital.
Results: The combined end-point was determined in 72 patients from the entire acute STEMI population (40.6%), including 24 events for 786TT genotype, 23 events for 786TC genotype and 25 events for 786CC genotype. Kaplan-Meier curves demonstrated that acute STEMI patients with 786CC eNOs genotype had lower MACEs free accumulation when compared to those with 786TC and 786TT eNOs genotypes at 6-month follow up period (Log-rank p < 0.001). Multivariate Cox regression analyses identified 786CC in eNOs gene as an independent predictor of clinical outcomes in STEMI after PCI.
Conclusions: the 786CC polymorphism in eNOs gene is an independent predictor for clinical outcomes after a successful primary PCI in acute STEMI.
Pazopanib is a new tyrosine kinase inhibitor which acts as anti-VEGF signaling and antiangiogenesis. In some countries, this drug has been approved for the treatment of advanced, or metastatic soft tissue sarcoma. Nevertheless, the efficacy of Pazopanib has not yet been proven in patients with advanced liposarcoma. We reported a rare case of advanced liposarcoma that after several courses of chemotherapy, the disease was relapsed, and CT-scan results showed lung metastasis. Therapeutic measures, including surgery and chemotherapy with pazopanib, were successful in destroying the metastatic mass in the patient's lung. Our finding provides a new therapeutic approach for pleomorphic liposarcoma.
Background: Taurodontism is considered a variation in tooth morphology associated with several syndromes.
Case Presentation: This report presents a case of taurodontism associated with drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. A 5-year-old girl, with a history of DRESS syndrome, was referred to the department of pediatric dentistry at the School of Dentistry, Shahid Beheshti University of Medical Sciences, with a chief complaint of toothache. Clinical and Radiographic examinations showed deep carious lesions with large pulp chambers and short roots present in relation to second mandibular primary molars. Routine pulpectomy could not be performed as a result of complex tooth morphology. Instead, we played a deep pulpotomy with calcium-enriched mixture cement agent, and the crowns were restored. Follow-up observations after six and 12 months showed that the tooth was asymptomatic, clinical and radiographic examinations revealed no swelling, no sensitivity to percussion and palpation.
Conclusion: In patients with carious taurodont deciduous teeth, deep pulpotomy with biomaterials such as calcium-enriched mixture cement can result in favorable outcomes.
The distribution pattern of internal iliac artery (IIA) implies its bifurcation to two branches, the anterior and the posterior trunks. According to previous research, IIA indicates several anatomical variations. The purpose of this study is to evaluate the types of these variations. The presence of these variations in the arteries is an important topic to urologists, gynecologists, radiologists, and general surgeons because they can be ruptured during surgical procedures in the perineal and pelvis region. Three databases were searched for the period from 1810 to January 2018 and a total of 75 studies were investigated. This study evaluated the branching of the internal iliac artery in several literatures and compared it with Adachi's classification. This finding can lead to improve surgical technique and safety in medical practice.
Introduction: Feeding habits and environmental factors may rival genetic susceptibility as etiological factors related to various cancers. Humans are continuously exposed to many synthetic food additives, one of which is sodium nitrite (NaNO2). There is a direct correlation between increases in consumption of nitrite-treated products and incidence of tissue damage, hepatotoxicity, nephrotoxicity and some types of cancer. The objective of this study was to investigate the protective effects of Trigonella foenum-graecum (TFG) on NaNO2-induced hepatotoxicity and nephrotoxicity.
Methods: Forty rats were randomly assigned (10 per group) to control (physiological saline solution), TFG (150 mg/kg/day), NaNO2 (80 mg/kg/day), and NaNO2+TFG (80 mg/kg/day + 150 mg/kg/day) groups. This group was offered TFG seed extract two hours before NaNO2. At the end of three months, the rats were decapitated, and blood, kidney and liver tissues were removed.
Results: Three months of oral administration of NaNO2 increased serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea, creatinine, and pro-inflammatory cytokine levels in the liver and kidney tissues [except for liver Interleukin 1 alpha (IL-1a)] of rats. Serum AST, ALT, urea, creatinine, liver IL-6, and kidney tumor necrosis factor-a (TNF-a), IL-6, IL-1a levels significantly decreased in the NaNO2+TFG group compared to the NaNO2 group. Pathological examinations, it was determined show that exogenously administered TFG could alleviate the effects of NaNO2 hepatotoxicity and nephrotoxicity.
Conclusions: Our results suggest that exogenous TFG mitigates NaNO2-administration induced hepatotoxicity and nephrotoxicity. TFG extract exerted antioxidative and anti-inflammatory effects, and played a significant role in preventing hepatic and renal damage induced by chronic NaNO2 administration.
Introduction: Arteriovanous (AV) access failure is one of the main problems in patients with end stage renal disease (ESRD), who receive hemodialysis. Balloon angioplasty is a favorable method for managing vascular access failure. The purpose of this study was to compare the six-month efficacy of paclitaxel-eluting balloon and plain balloon angioplasty in failed AV access cases among hemodialysis patients.
Methods: In this quasi-experimental study (http://en.irct.ir/trial/35333), 50 hemodialysis patients with failure of AV access (stenosis > 50%), who were candidates for angioplasty, were included. They were divided to receive either paclitaxel-eluting balloon (25 patients) or plain balloon (25 patients) angioplasty. Patients were followed up for six months with color Doppler ultrasonography and clinical examination for the hemodynamic success rate of angioplasty.
Results: After six months, 19 patients (76%) in paclitaxel-eluting balloon angioplasty group achieved hemodynamic success, which was significantly higher than plain balloon angioplasty group (13 patients, 52%) (P = 0.012). Age, gender, diabetes mellitus, hypertension, and location of AVF (snuff box, forearm, and antecubital fossa) did not associate with hemodynamic success rate in any group.
Conclusion: The use of angioplasty with paclitaxel-eluting balloon was superior to plain balloon angioplasty for failed AV access cases in hemodialysis patients. It is recommended to use paclitaxeleluting balloon angioplasty in patients with failure of AV access and requirement for balloon angioplasty.
Introduction: With 170 million chronic hepatitis C virus (HCV) cases worldwide, HCV is considered a major life-threatening pathogen. HCV is a crucial causative of liver cirrhosis and hepatocellular carcinoma. Tumor necrosis factor-alpha (TNF-alpha) is thought to be a mediator in the development of viral hepatitis. Because HCV is epidemic in Egypt, this study aimed to characterize the distribution of TNF-alpha gene promoter polymorphisms and their relation to TNF-alpha expression in HCV patients.
Methods: Four promoter polymorphisms; âˆ’1031T/C, âˆ’863C/A, âˆ’857C/T, and âˆ’308G/A, were studied by restriction fragment length polymorphism in a population of Egyptian HCV patients.
Results: Compared to healthy subjects, none of these polymorphisms were associated with HCV infection. The wild-type âˆ’1031T, âˆ’863A, âˆ’857C, and âˆ’308G alleles were highly prevalent in the studied population. Sequencing the promoter region spanning the four studied polymorphisms in some subjects did not reveal any difference in the nucleotide variance pattern, compared with the TNF-alpha reference sequence. Relative TNF-alpha mRNA expressions in HCV patients and healthy subjects were statistically indifferent.
Conclusion: Since previous studies confirmed an increase in TNF-alpha level in case of viral infections, this study focuses on mechanisms of post-transcriptional and posttranslational modifications of TNF-alpha gene in HCV patients, which decode the genetic factors linked to HCV infection and severity.
Glycans are carbohydrate components of glycoconjugates, which interact with their receptors; for example, galectins and C-type lectins. The specificity to their receptors makes them the ideal biomarkers that they can be used as a therapeutic target or as a screening tool. We collected and reviewed articles from different databases, which show that glycans play a significant role in several body functions, such as stimulation of the immune system, and can be used in the differentiation among cancer types. They also help in nervous system repair, regeneration, regulation and proliferation. Furthermore, several pathogens like Schistosoma, HIV, Influenza, Candida, and Ebola produce glycoproteins to aid in the invasion via attachment to surface glycoproteins and defend themselves against the host's immune system.
Introduction: Three percent of people worldwide are infected with Hepatitis C virus (HCV). A few studies have been performed to evaluate the biochemical markers of the disease. In the current study, biochemical markers were evaluated in HCV patients and the control group.
Methods: Two sex- and age-matched healthy individuals (n = 100) and HCV positive patients (n = 100) were included (mean age of 20-75, 26.0% females and 74.0% males). Biochemical markers, including liver enzymes (ALT, AST and ALP), lipid profiles (cholesterol, LDL, and HDL) and triglyceride (TG) were investigated in both groups. HCV genotyping was also performed by Polymerase Chain Reaction (PCR) and OHNO methods.
Results: The biochemical markers between HCV patients and controls were compared (cholesterol, ALP, AST, ALT, LDL: p = 0.0001, HDL: p = 0.002, TG: p = 0.003), and statistically significant difference was found between two groups. The biochemical markers between HCV patients and the control group in terms of age was compared and no differences was observed (p = 0.741), however, there was a significant difference in sex between HCV patients and control group (26.0% females, 74.0% males in control group, and x% females and y% males in HCV patients) (p = 0.032). The results of HCV genotyping showed that 39 patients were genotype 1a, and 43 patients were genotype 3a, and 1 patient was genotype 2a. Evaluation of biochemical markers in patients with genotype 1a and 3a showed that there were significant differences in cholesterol (p = 0.001), LDL (p = 0.001) and HDL (p= 0.003) levels, but there were no significant differences in liver enzymes and TG levels in both genotypes.
Conclusion: In the present study, we found significant difference in biochemical markers between HCV patients and controls. In HCV patients, the biochemical markers were dependent on HCV genotypes, and their levels in genotype 1a were higher than genotype 3a. In conclusion, biochemical markers are one of the most important factors for the identification of treatment.